Thursday, December 13, 2012

A HORRIFYING PREVIEW OF OBAMACARE: 6 in 10 Veterans Administration claim denials are in error

So reports Army Times in a sobering report on the state of a typical, government-run health care system:

A new report on an old problem contains some sad statistics about veterans’ benefits claims:

• Thirty-one percent of claims filed with the Veterans Affairs Department are likely to be denied — and 60 percent of those denials will be erroneous.

• Sixty percent of claims will take longer than 125 days to be processed, more than 7 percent of claims will be misplaced, and 4 percent will be completely lost.

• A veteran calling VA’s benefits hotline has just a 49 percent chance of being connected to someone and receiving a correct answer.

...Based on a review of the 870,000 benefits claims pending before VA in 2011 — a number that has climbed to about 900,000 pending claims today... Even faster claims processing might be possible by contracting out administrative services or transferring claims processing from the federal government to states, the report says. It recommends expanded pilot programs to test those ideas.

The nonpartisan National Center for Policy Analysis, which specializes in retirement and health care programs, is skeptical about VA’s stated goal of eliminating the claims backlog by the end of 2015.

VA “is barely able to process current claims,” the report says, “and has exhibited little to no progress toward their stated goal of 125 days and 98 percent accuracy for processed claims by 2015.”

The federal government, in general, does a poor job of administering disability benefits and services, the report says, “as evidenced by the state of Social Security Disability.”

“But the Veterans Benefits Administration appears to be far worse.”

When Nancy Pelosi famously opined -- vis a vis Obamacare -- that we had to pass it to find out what's in it, she was wrong.

1 comment:

After working on the finanical side of a small, independent physician's office for 15 years, we have ceased taking VA patients for precisely these reasons. If, and I say IF, we actually get paid correctly on a clean claim, our reimbursement will be a Medicare levels or below. This usually is not cost effective to review claims again and again for the pittance we will receive.